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Title: Tropical sloughing phagedoena
Author: Rouget, Francois Augusta
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1906
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1.The Epidemic ulcers which prevailed in Mauritius in 1903, 1904 and 1905 were clinically identical with the Ulcers originally described as Ulcères de Mozambique, de Cochinchine, de Yérnen etc and now included under the generic ter:1 of Tropical Sloughing Phagedoena. 2. The disease affected almost solely people walking barefooted viz:-Indians and African creoles. 3. It prevailed with greatest intensity in the hot and rainy months. 4. In the majority of the cases, the phagedlienic process invaded preexisting sores or wounds, sometimes of a trifling nature. In a few cases, however, there was positively no history of traumatism. 5. In the majority of the cases, likewise patients affected were already depressed and weakened by some constitutional disease. The chief predisposing cause in this respect appeared to be Malarial Cachexia. 6. In a few cases, at the outset of the Epidemic, there was no coexisting constitutional diseases and the patients general condition was satisfactory. In such cases, the ulcers had invariably a mild character and were rapidly cured. 7. The disease presented itself under two different forms: a mild one and a severe one, the former being the predominating type in this Epidemic. 8. The disease proved very amenable to treatment as out of 852 cases treated in the hospitals of the Colony in 1904 only two had a fatal termination. 9. The local treatment which was found most successful at the Civil Hospital in the mild and moderately severe cases was repeated applications of pure Carbolic Acid or Phenol Carnphor. The severest cases necessitated surgical interference. 10. A notile Bacillus, morphologically and biologically identical with that described by Crendiropoulo in 1897 in Ulcère de Yémen, was present in all cases in the exudation from the cleaned ulcer. 11. The constancy of the presence of this Bacillus in very large number and frequently alone in the sores tends to indicate that it is really the micro-organism concerned in the etiology of the Sloughing Phagedoena which prevailed in Mauritius in the last three years. 12. The great motility of this Bacillus, as contrasted with the absence of motility in the case of Vincent's Bacillus, would indicate that Tropical Sloughing Phagedoena is distinct from the Hospital Gangrene of Temperate Zones. 13. The fact that only barefooted individuals were attacked and the lower extremities usually affected would show that the usual habitat of the pathogenic organism concerned was probably the soil. 14. The contagiousness of the disease was not clearly demonstrated, at least to my knowledge, in this epidemic. Instances of secondary infection in the same person were met with but there was no evidence of the disease having spread by contact among members of the same family. In the interesting case referred to above where the typical phagedenic ulcer was detected in the Vagina, the mode of infection could not be traced for obvious reasons, the patient being unmarried.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available